Transcripts For CSPAN Infectious Disease Experts Testify On Coronavirus 20240713

They also cautioned against the misinformation on social media regarding the coronavirus. This house, science, space and Technology Hearing meeting is out is about one hour and 40 minutes. This hearing will come to order. Without objection the chair is authorized to declare recess at any time. Good morning and welcome to the hearing on coronavirus, understanding the spread of the Infectious Disease and mobilizing Innovative Solutions. I will recognize myself for an Opening Statement and then i will recognize the Ranking Member for his Opening Statement and i will introduce the witnesses. Again, thank you for being here. Obviously this is an incredibly timely process. Covid19 is not the first pandemic we are ever going to deal with and certainly not the last one but it is incredibly important that we come together as a nation and as a planet and become to get ahead of this and address it and come up with treatment for it. If we think about Global Health security to threepronged approach. Containment medication and treatment. This is the third hearing that im chairing on the subject and the hearing is focused on the containment. It was the first hearing the congress held. The conclusion of that was the initial strategy of trying to contain this disease with travel bans, etc. , was likely not going to be successful. Very difficult. What china did was ambitious and bought us some time but most of this in the Public Health world and im a physician by background in a large Public Health system recognize we have likely seen committee cases that would be difficult to stop the threat of this disease. The second hearing we had last thursday was on mitigation. Largely looking at testing, and this was last thursday after the First Community spread case hit my hometown of sacramento where a patient was hospitalized at the university of california davis Health System where i used to practice. What we discovered was the testing criteria were probably too rigid that we were missing a lot of community tests and we also started to discover the ability to test folks, the availability of test kits, etc. Was largely not there. I am pleased to share with the Vice President yesterday and things are ramping up. But we probably lost quite a bit of time and we are likely going to see many more Community Cases probably in all of our congressional districts. So, there is a lot to be learned from the bureaucratic breakdown that prevented us from rapidly getting those tests out there. Todays hearing is focused on treatment based on science and what we can learn from how the virus initially developed, what we can learn from looking at the chinese response, we now have a big data set, how did they manage those folks. China is a communist country so they are able to do things that we cannot do as a democratic nation. We respect individual rights and individual freedoms here, but there is still a lot we can learn from how they did surveillance, etc. Especially given the breadth of contact thats likely going to do based on the community pieces that we are going see you cross the United States. We will not have enough epidemiologists, the cdc will not have enough personnel, so what can we learn and how china and korea. If you are looking at the data coming out of korea now, their aggressive approach to testing and communitybased testing, they were doing 18,000 tests a day, may have actually mitigated and reduced how bad the response could have been. So i think that is going to be incredibly important. We are also going to look at the science of how is it spread and how efficiently is it spread. How long can this virus live on inanimate objects. I think this is an incredibly timely hearing. This is a Science Committee so i am glad we are looking at the science of this, and i appreciate the witnesses here, bringing their scientific expertise to help us better understand this disease. With that, the chair recognizes Ranking Member mr. Lucas for his Opening Statements. Good morning and thank you for holding this important hearing as we deal with an emerging and rapidly evolving situation with the spread of coronavirus, covid19. According to the centers for Disease Control at this time most people in the United States have little exposure to the virus, however Public Health experts advise us a pandemic is likely, so we must gather the facts and be prepared. Today i hope our expert witnesses can provide expert Important Information we can share with our constituents. I also hope we can learn what tools are needed to detect and predict and prevent the next pandemic. Covid19 was first identified in wuhan, china in december of 2019. Since then, the World Health Organization has reported over 90,000 confirmed cases and over 3000 deaths throughout 76 countries. In United States, the cdc has reported at least 152 confirmed cases and 11 deaths. We know that for most individuals the illness is not serious, but we are getting information on the death rate. The impact on vulnerable populations is particularly concerning though, and my thoughts are with the individuals and families have been affected. This is not the first Global Pandemic in modern times and im quite certain it wont be the last. Just over 100 years ago the world faced one of the deadliest pandemics in history. Alsovian flu pandemic, known as the spanish flu, which killed an estimated 50 Million People worldwide including over 600,000 people in the United States. Since 1980, outbreaks from emerging Infectious Diseases have been occurring with greater frequency and have been causing higher numbers of human actions than in the past. The vast majority of these infections are initially caused by the spread of the disease from animals to humans. The sars in 2003 outbreak and the avian outbreak in 2006 were wake up calls to the american Public Health system. And congress made considerable investments in improving our nations capacity to detect and respond to pandemics. We would be in a much worse position without those investments. Im confident that the u. S. Government has the tools necessary to deal with this. We have the best scientists in the world with nih, the cdc, and in our universities. Their work has yielded considerable advancements in health technology, disease surveillance and Predictive Modeling as well as medicine, drugs and Vaccine Development. Technology like Artificial Intelligence and greater availability of data we are able to identify and track outbreaks faster. We also modernize the pandemics preparedness act to set up a framework to deal with precisely this type of outbreak. While significant progress has been made, gaps remain, and the severe pandemics like the Novel Coronavirus could be devastating to the global population. As the human population has livestock,as the swine, and poultry populations needed to feed us. Is the number of host provides increased opportunities for viruses and birds cattle and pigs. The spread of evolve into people. To better understand how diseases like evian flu, swine flu, ebola, zika, and sars and now the Coronavirus Spreads and operates we must invest in the basic research to learn more about the interconnection between people and animals and plants in shared environments. Yesterday the house passed a supplemental appropriations bill to address the response and the development of a vaccine. I supported the bipartisan bill and i hope my colleagues and i can Work Together on a longterm strategy to prepare for any Global Pandemic we might face in the future. Our top priority is the health and welfare of the American People. I am pleased the president has created the corona task force. This Interagency Group is working to contain and mitigate the spread of Novel Coronavirus while ensuring the American People have access to accurate and uptodate travel information. The best things americans can do is to follow the guidance of the cdc. Many of the recommendations are simple ones. Youll learn from your mother. Wash your hands, wash your hands, do it frequently, cover your mouth when you cough or sneeze, avoid touching your face and stay home if you are sick. I want to thank the witnesses for taking the time to share their expertise with us during this crucial time to help keep american safe, healthy, and secure. With that i yield back the balance of my time, mr. Chairman. If there are members who wish to submit additional Opening Statements, your statements will be added to the record at this point. At this time it like to introduce our witnesses. First we have dr. Suzan murray. . She is the Program Director for the Global Health program at the Smithsonian National disease and conservation biology group. Nest is dr. John brownstein, the chief innovation officer at boston Childrens Hospital and professor at harvard medical school. Third i welcome dr. Peter hotez, who will be introduced by the chair for the subcommittee on energy. Thank you very much mr. Chairman. Its truly a privilege and a pleasure to introduce an internationally recognized physician scientists and Global Health with tropical diseases and Vaccine Development who is also my neighbor and a cheerleader in our community. Dr. Hotez is a professor at college of medicine and codirector of texas Childrens Hospital for Vaccine Development as head of texas general Vaccine Development he leads the partnership for developing new vaccines for a variety of diseases including other human coronaviruses like sars and mers , diseases affecting hundreds of millions of children and adults worldwide, while championing access to vaccines globally and in the United States. Dr. Hotez, welcome. We are glad to have you here today. And lastly we have dr. Tara kirk sell. A senior scholar at Johns Hopkins center for Health Security and assistant professor at Johns Hopkins school of Public Health. You will each have five minutes for your written testimony and for spoken testimony and your written testimony will be included in the record. When they have completed your testimony we will begin with questions. Each member will have five minutes for questions. Dr. Murray, you may proceed. Dr. Murray thank you very much. Congressman bera, Ranking Member lucas and all members of the committee, thank you for calling this hearing and inviting me to participate. Andame is dr. Suzan murray i am director of the Global Health Program Based of the National Zoological park and conservation biology institute. My program utilizes experts and wildlife medicine human medicine publichealth conservation biology and epidemiology to study and respond to Health Issues the human animal interface. We utilize a multidisciplinary approach to investigate emerging Infectious Diseases that threaten both human and animal life and we build capacity to train the next generation of health specialists. In short, this is the reason right now that our program was created. Human health wildlife and Environmental Health are inextricably linked and depend upon each other. In order to safeguard the survival of all species, its critical that we examine Health Across the continuum of species and have research and decisions firmly rooted in scientific knowledge. Understanding the current viral threats, the patterns and drivers of disease emergence, and that Human Behaviors that contribute to such emergence will best allow us to not only respond to this outbreak, but the next one and the one after that, because we do know they are coming. Already we have identified many of the drivers of disease emergence and spread including landuse change, increased human wildlife interaction, and the globalization of travel and markets. Time and history have repeatedly shown us that it is much more humane, efficient, and economical to prevent disease rather than to identify a andspond, diagnose, treat, contain an outbreak. To increase understanding of the as yet undiagnosed virus is the drivers of emergence and the risk factors associated with variance behaviors, we can develop Early Warning systems, prepare Rapid Response teams, and provide Critical Data and information to the vaccine industry to better prepare for the next outbreak. Just as critical, we must educate medical professionals and the People Living in the communities at the greatest risk of outbreak. By preventing the spread of pathogens at the source, we can avoid the global consequences we are experiencing now. For example, over the last 10 years and working with partner agencies, our team has collectively identified over 1200 novel viruses. 1200 is a lot of viruses. It is only a small amount of the ones that are out there. 161 of these belong to the same family as covid19. In this time, we strengthened the capability for virus tension virus detection and characterization in six new labs in which pandemics are most likely to originate. We have also trained over 6000 people in more than 30 countries at the front line of defense against emerging diseases. At this moment, the world is focused on the Novel Coronavirus, as it should be. While it is essential we do everything we can to respond to this global crisis, it is also the time we need to be thinking of emerging viruses. The next Global Pandemic is not a matter of if, but when and where. To quickly identify and contain such infections, health and disease must be evaluated across species and on a global scale. While he might not have imagined in this context, ben franklin was right when he said one ounce of prevention is worth a pound of cure. When it comes to outbreaks, the cost of responding to a crisis can dwarf investment in research and education. Beyond the obligation to protect human life, there are financial benefits from focusing on preventative measures. For example, the human and economic toll from the west african Ebola Outbreak was massive. More than 11,000 people lost their lives, and well over 4 billion was spent globally. In the case of the sars epidemic of 2004, the estimated Global Financial impact was between 30 billion and 50 u. S. Billion in situation isnt expected to be on orders of magnitude higher. Advancements in the detection of novel pathogens show the most efficient way to respond to and contain an outbreak is through the coordinated wildlife and human surveillance. While we estimate there are 1. 7 as yet unknown viruses, about half of which can affect human people and some lead to new pandemics. As of now, there are no coordinated programs to work in highrisk regions to identify these viruses, get their genetic sequences into labs, and identify ways to reduce risk of them emerging. Our best defense against spreading diseases that make their way into the human population is through research and education. While we cannot stop every disease outbreak, we can reduce their frequency and build the capacity for a rapid Global Response when they do occur. Thank you once again for this hearing and your interest in this pressing and important topic. I look forward to answering any questions you might have. Congressman bera, Ranking Member lucas, and distinguished members dr. Brownstein, could you turn your mic on . Dr. Brownstein that would help. Congressman bera, Ranking Member lucas, and distinguished members of the house of Representatives Committee on sciencebased technology, thank you for inviting me today to speak with you. Today i will describe ways the novel technologies like Artificial Intelligence can help detect monitor and predict emerging Infectious Diseases. I will also discuss how nontraditional sources can supplement technological techniques. But as i described the good news, i do not want to sugarcoat the bad. We urgently need federal and local investment of new technologies for Public Health surveillance and response. Such investments will augment the capacity and publichealth to implement new ways to monitor the healthy population. It will deepen our understanding of communitybased mortality. It will also save lives. This is the goal in boston Childrens Hospital where we develop technology and use freely online information to provide insights to agencies and the general public. We did this for the h1n1 influenza pandemic, avian influenza, ebola in west africa, and covid19. These platforms ultimately played a Critical Role in the Innovative Surveillance technology to help detect monitor and mitigate these diseases. Our project which is available to the public brings together sources from a variety of places to help provide a unified view of the world of Infectious Diseases. , to dues that we use ai Machine Learning, natural leg which processing to organize the information to make it available. Example. In december 30, 22019 heres an example. On december 30, 22019 platforms ordered system unknown viral outbreak. Using ai is one of years of research into the potential disease and word spreads. Machine learning models can predict where viruses may arrive next. That helps us inform Public Health how to respond. Predictive modeling can be used with data like prior disease history whether Laboratory Data symptom surveillance altogether through ai help us Exchange Information and conduct surveillance and measure public response to the events and response. Supportso critical to sentinel surveillance which allows publichealth information impacting the community. One example is the cloud serving platform. It identifies an individual who may need medical attention in realtime. Our team has augmented this tool to improve covid19 surveillance. To date, there is no evidence supporting widespread transmission of covid19 u. S. But it suggests the same transition at the Community Level will be occurring. Current global situations make sure this outbreak will become a pandemic. It threatens the health of the people of the United States and globally. The covid19 outbreak also demonstrates some reason for optimism. It demonstrates what we can accomplish when scientific disciplines unite around a common goal. Each outbreak may require a different approach, but there are key updates in metrics we need in every single outbreak. There are questions we must ask. How many cases are there . What is the geographic spread . Our Health Care Workers affected . We cant answer questions by using forms along with traditional surveillance could we agree data from a right of sources in realtime. There is a epidemiological expression that says what we want. In english this means risking some false positive to uncover more of those who are sick. These platforms do that. They aggregate everything available to provide stakeholders of the snapshot of the current view of the situation. Those within the realm of Infectious Diseases often say its not a matter of if but a matter of when. We continually need support for initiative to to impact domestically and globally Infectious Disease monitoring surveillance. By investing in our neighbors and promoting Health Initiatives outside of our borders, we help reduce the threat of an outbreak reaching the u. S. There is another essential step to being prepared. Longterm support from Disease Control and prevention at the local department of health. The cdcs influenza Surveillance Systems are the backbone for this country. Augmenting this Surveillance System with novel programs like health net provides Additional Information that allows the Public Health, authorities, clinicians, researchers and the general public to stay alert of whats happening. This is why i urge this committee to make sure the u. S. Provides the same investment in the fundamental leaps of this to detection of surveillance. That means domestically and around the world. Nontraditional data sources and Machine Learning have proven their worth. They support traditional surveillance and aid in a clear path and picture of existing diseases as a threat in human health. Youve shown for your thoughtful leadership in the past and now we need your help again. With your continued support we cannot only strengthen the Public Health community, we will protect the lives we serve. Thank you again and i look forward to your questions. Dr. Hotez thank you very much. Ranking member lucas, thank you for that very generous introduction. I would also like to acknowledge my fellow texan. It is an honor to be here. I always get thrilled when i have the opportunity. Ive been doing this for 20 years, to address committees in congress is still a special thrill to me. Am a vaccine scientist and pediatric scientist. I was previously chair of microbiology at George Washington university and a decade ago we moved to texas to create a unique school for emerging tropical diseases and to create a unique center for Vaccine Development. And the need was this. There is an urgency to create vaccines for diseases which dont make money. So, we took this on with the idea of pioneering not only interesting science, but a new Business Model. And the Business Model part we have not figured out yet because we are trying to make vaccines that no one else can make. The vaccine that we hope will attend to the clinic soon and a hookworm vaccine in Clinical Trials, a new vaccine moving into the clinic. I would like to say these are the most important diseases you have never heard of, some of the most common afflictions of the worlds population, but mostly occur among people who live in extreme poverty. So there is no model to figure out who will pay for them. So there is a consequence in that night of the big biotechs or fios to michael or pharmaceutical companies will make the vaccine. We also took on a decade ago of making coronavirus vaccines because we recognized these as enormous publichealth threats yet we have not seen the big pharma guys rushing into this space. We partnered to take on the big scientific challenge of coronavirus vaccines. And i say a scientific challenge, because one of the things we are not hearing a lot about is the unique potential safety problems of coronavirus vaccines. This was first found in the early 1960s with respiratory interstitial virus vaccines done here in washington with the nih and Childrens National medical center. That some of those kids who got the vaccine did worse, and i believe there were two deaths. Because what happens with certain types of respiratory virus vaccines, you get immunized and when you are exposed to the virus you get this paradoxical enhancement phenomenon. And we dont entirely understand the basis of it, but we recognize it is a real problem with certain respiratory virus vaccines. That killed the rsv program for decades and now the Gates Foundation is taking it up again. But when we started developing coronavirus vaccines we noticed in Laboratory Animals that they started to show some of the same immune pathology that resembled what had happened 50 years earlier. We said oh my god, this is going to be problematic. But we collaborated with the group that figured out how to solve the problem. That if you narrow it down to the smallest subunit, the receptor that docs with the receptor, you get protection and you do not get that and you know enhancement phenomenon. We posted it to the National Institute of allergy and texas diseases. They funded it and we wound up actually making and manufacturing in collaboration with Walter Reed Army research a first generation sars vaccinator vaccine. Sars was the one that emerged in 2003. And then his new one of course we called the sars ii coronavirus. We had it manufactured but we could never get the investment to take it beyond that. That was really unfortunate because we had the vaccine ready to go but we could not move it into the clinic because of lack of funding because by then no one was interested in coronavirus vaccines. When the chinese started putting up the data in january and february, we saw a very close symbology between the two and we might be sitting on a very attractive coronavirus vaccine. Now youre working again with nih and others to get the funding. Now we will have that lag. These trials are not going to go quickly because of that immunity. Its going to take time. Unfortunately some of my colleagues in the biotech industry are making inflated claims, youve seen this in the newspapers we will have this vaccine in weeks, but what they are really saying is they can move effects into Clinical Trials. But this will not go quickly. As we start vaccinating volunteers especially in areas where we have Community Transmission we are going to have to proceed very cautiously. The fda is on top of this. They have a great team in place. They are aware of the problem but its not going to go quickly. We are going to have to follow this slowly and cautiously to make certain we arent creating an enhancement. Now we are hearing projections, one year, 18 months. Who knows. We are not going to go quickly. But the bottom line is that we have those investments early on to carry this all the way to Clinical Trial years ago we could have had a vaccine ready to go. We have got to figure out what the ecosystem is going to be to develop vaccines that are not going to make money. The Big Pharma Companies are not going in. Are of the biotechs starting to because they are trying to accelr8 technology and hopefully flip it around for Something Else that will make money. Morehappy to explore that during the questions. Dr. Sell good morning. Thank you for inviting me to speak about my research on misinformation. This research in context of covid19 and ways to support research that improve outbreak response. Traditional disease surveillance is critical during an Infectious Disease outbreak. However disinformation can be supported with tools to support decisionmaking. One such tool is crowd forecasting. It consolidates the divers opinions of many to hard probabilities or future outcomes. This is helpful in gauging the most likely outcome but also for understanding the uncertainty about the outcome. Over the past year my Research Team in partnership with a group called hyper mind developed the crowdsourcing production platform and asked forecasters to make addictions about outbreaks. We asked about the spread of measles in the u. S. , and how many u. S. Counties might see cases of eastern equine encephalitis. Had accurateers productions about three weeks ahead of time. Recently we focused our forecasting platform on covid19 and we asked about the number of countries that would have cases of covid19, and the number of cases that will be seen around the world and in the u. S. For global cases, forecast s showed high confidence in a rapid and explosive spread. On a few occasions are predictions were incorrect. We think this is probably because forecasters did not have enough information to make accurate forecasts. Essentially there is no magic here. If information is lacking or is delayed, forecasters do not have information to go on. This underscores an essential Research Need for the current covid19 outbreak. That surveillance within the u. S. And globally is essential. Another area of my research , misinformation during disease outbreaks, has emerged as a challenge during the covid19 outbreak and highlights the need to transparently and rapidly share information. Health misinformation can be defined as falls false Health Related information and can range from the promotion of rumors about the origin of the outbreak. This information can impede the effectiveness of Public Health response measures, increase societal discord, reduce trust in government leaders and responders, and increase stigmatization. My team and i analyzed information the west african Ebola Outbreak. One of the most recent examples of a fear inducing disease event for the u. S. Public. Our analysis we found 10 of the ebolarelated tweets had false or misinformation. We also saw more disinformation was political designed to promote discord. Another finding was parallel to covid19 was the infection identification of rumors often focused on government conspiracies. Although we have not been able to use systematic analysis of covid19 misinformation we have seen the spread of false information including fall skewers that could be harmful, blaming specific ethnic groups, and conspiracy theories about various governments creating the virus as a bioweapon. Response to misinformation requires a nuanced approach and further research to best determine the way forward. While the solutions will be complex, one thing that is critical is the prevention of information void that can be filled with false information. Members of the public need accurate and timely information to help them make sense of whats happening in the outbreak. As i advocated for improved surveillance earlier, this shows the need for better collection of disease information in a transparent and rapid manner. From my experience in conducting research in response to emergency outbreaks, i believe we need to reduce the impediment and disincentives to doing rapid and Timely Research during these events. One hurdle to overcome is the slow process to establish establish federal funding streams for research during a response. My research was funded by a word awards from private groups prior to the outbreak which provided the flux ability to shift gears toward covid19. And while the development of vaccines and countermeasures are critical, social, behavioral, and Epidemiological Research is also important. The best treatment cannot be effective without knowing where the disease is and who it is affecting. The best vaccine cannot change the course of an outbreak if people refuse to take it. And the above occult response cannot be implemented if members of the public to our not public dont cooperate. My bottomline message is this, we need to support the systematic collection and rapid dissemination of information about outbreaks. As the issue of misinformation grows, a dedicated effort to understanding the best way to combat it will be needed. Even after the covid19 a break will be over, emerging outbreaks will still be a continuing concern. The federal Research Space needs to evolve towards a more rapid approach to meet this threat. Thank you. I would like to bring the committees attention to a letter that chairwoman johnson received in preparation to todays hearing. Letters from johnson and johnson that highlights their Global Response to the covid19 virus. Without objection i am plaguing this document in the record. At this point well begin our first round of questions. The chair recognizes himself for five minutes. Dr. Hotez, you touched on some of your research into developing a coronavirus vaccine, a sars vaccine. I think its incredibly important. Dr. Sell just talked about information and misinformation. We have heard quite a bit about how quickly we will get a vaccine and how quick that will be available to the public. This morning i woke up to a news alert that said cambridge, massachusetts bio company came up with a vaccine that they wanted dr. Fauci to start testing. But we have to be honest to the public so as to not give them false hope. If you can go through a timeline on what vaccine developed is going to look like, in the best case scenario, onto Clinical Trials, and potential public availability. Dr. Hotez thank you for that question. I think what we are going to see over the next few weeks to months are several vaccines will enter into a pipeline of Clinical Trials. Hopefully ours will be one of them. You mentioned the vaccine out of m. I. T. Theres certainly will be in there. There are five or six. About five or six and maybe a couple more. But then its going to go into a bottleneck, and that bottleneck are the Clinical Trials. Phase one, phase two, phase three trials. Despite what the antivaccine lobby likes to claim that vaccines are not adequately tested for safety, in fact, among pharmaceuticals, vaccines are the single most tested pharmaceuticals we have for safety. It takes time. Because you have to initially do in injection in normal holland veal tears normal human volunteers to show it is safe, and show it actually works. Now you have the added complexity, because you want to make certain the volunteers when they are immunized in transmission do not get worse. I cannot emphasize enough how lucky america is to have that group, some of the bed the best Public Health scientists in the world will follow this very closely. And thats not quick. Best case scenario, dr. Fauci said at least 12 months. Dr. Hotez hes definitely right, at least 12 months. But whether that means another year after that really depends on the safety signals we have seen with these vaccines. The ability of our commercial pharmaceutical sector to quickly ramp up and develop that vaccine and make it commercially available, is that going to be an issue . Dr. Hotez there is a lot of press releases from the biotechs. Some of them i am not very happy about, frankly. I think it is telling only half the message. It took us years to develop vaccines. It is an old method, but we know it works because we have had the hepatitis b vaccine license with this technology, hpv vaccine with this technology. Now you are seeing generation platform vaccines. It is a very Exciting Technology because you can use quickly into Clinical Trials. The problem is you do not have a single licensed vaccine with that technology. The idea all of a sudden that is going to work. Historically these have worked very well in mice and Laboratory Animals, but they have not been reproducible in people. Organizations have gotten around it and they have fixed it, so maybe they have. But we dont have a lot of experience. We are moving at an incredibly rapid pace right now. The people need to understand there may be a vaccine in 12 month or longer, potentially longer than that. Dr. Hotez look at ebola. The first ebola vaccine started rolling out in 2015 in the epidemic in west africa. It was not until 2019 that we really got it rolling. By the way, one of the most Extraordinary Health stories ever told. Let me ask dr. Sell a question. Based on your research, as you are observing this, what are some of the common oninformations out there covid19 . Dr. Sell there is misinformation about fall skewers. There are no cures out there right now. So all that is false. Theres disinformation about government conspiracies. That someone else started the disease. I think there is also misinformation about the disease, what characteristics it has. I think theres a lot that we dont know. So theres that information void that people are just filling with their ideas. It behooves this institution and each and every member of congress to make sure we are in tight communication with our constituents back home. The that, let me recognize Ranking Member with mr. Lucas for five minutes. Thank you. Thinking about those comments, lets begin from the perspective being your neighbor of north and all, in oklahoma. As of lifes night as of last night, there are no confirmed positive cases of coronavirus in oklahoma as of yesterday evening. Although one oklahoman showing symptoms is awaiting on test results from the cdc. Can you discuss for a moment what we can share with our constituents back home to not instill panic and how to stress the importance of reasonable steps to prevent spread. Dr. Hotez i know oklahoma pretty well. My son graduated from ou just last year. Petroleum engineers. We love norman. The issue is this. I think an attempt to calm public fears, youre hearing things like is a mild illness. This is like flu. It is not really the case. Because this is a really unusual virus. Especially for young people, its a mild illness but we are seeing some devastating things. We got a heads up about this from the chinese. They actually informed us, and we knew it was coming. Nursing homes. Look what this virus did in that nursing home in kirkland, washington. It rolled through it like a train. At least seven deaths so far in a nursing home with about people. 100 so this is like the angel of death for older individuals. We need to go back and support all of our Nursing Homes. I dont know what we are doing wrong. But clearly that nursing home was not prepared for this, and i am going to guess Nursing Homes across oklahoma are not prepared as well. Also, our Healthcare Providers. We saw in wuhan, 1000 Healthcare Providers get sick. 15 severely least ill and in icus. That is very dangerous. Because not only do have subtract those people out of the workforce, but the colleagues taking care of colleagues. The whole thing can fall apart if that starts to happen. I was on governor perrys task force for Infectious Diseases. When theyicu nurses, got sick it was really devastating. Finally the governor, the cdc director said look, normal icu units cannot take care of these patients. We have to get them out of here. You do not want to see those kind of situations. I am worried about our first responders. They are already in quarantine. Does that mean we have to bring in the National Guard . That will be another big issue as well. Those are the vulnerabilities three that i see right now in a place like oklahoma. How should our constituents back home react to that . Dr. Hotez the average public needs to hear from its elected leaders, from the governor, the Public Health authorities, what plan is. Dont just get up there and say this is a fluke, this is a mild illness. True and people are smart and will figure that out quickly. Second, explain what the risks are. These are the three vulnerable populations that we have to worry about. And here are the steps that we are doing to mitigate that. That is what people will appreciate. Doctor murray, as you mentioned in your Opening Statement, approximately 75 of diseases emerge as pathogens. 1. 7 many unknown viruses yet to be discovered around half of which we are capable of infecting people. Could you expand and elaborate on the current state of research to improve surveillance in these diseases and where gaps may exist now . As we look towards addressing future challenges . Dr. Murray thank you very much. I also appreciate that while we are trying our best to address the topic at hand, there are a lot of ill people. We need to be thinking about the next virus and the next virus. I also think the cdc has done a wonderful job of looking at and studying human health. And if we are going to do our best job, to prevent future viruses from jumping, i think one of the missing components is wildlife health. 75 of the viruses come from the wildlife, so it makes sense we look at that junction, both wildlife and human health. We also, this virus has turned a novel virus. It is no. It is new to the people. I dont think its new to the bats. Thats an important point. And some of our other colleagues here have been talking about modeling and how important that is. Modeling gives us greater information now as to what cuvee did we doing within the u. S. And within other countries. We also have groups of modelers who look at the forefront of the stages and look at the data we have to try to determine where are the hot zones, what are the risk factors, and behaviorally, what are people doing to put themselves in danger. Those are really important ways for us to get ahead of the curve and catch the viruses before they come out. As part of the team that we have been on, we have a team of modelers who look at viral emergence and they are able to determine for each different virus, as we collect more and more data, what percentage of the viruses that we know are characterized and how many more are likely to be out there. Latest estimates are less than 1 . The viruses that we know are less than 1 of the viruses that are out there. Meaning theres over 99 viruses in wildlife waiting to jump into humans. That is staggering. And its really one of the things that we need to look at. Thank you. My time has expired. The gentlelady from oregon is recognized. Thank you. This emergent coronavirus epidemic is a top concern for oregonians. And im glad we are having this hearing today. In oregon we currently have three individuals who tested positive, two whoj are in who are in the district i represent. Plus an additional couple of additional constituents in japan. We know the transmission is likely. It is clear from the tragic deaths in washington how this virus can spread quickly because and because serious harm. So lets take a moment to reflect on those who have lost their lives in our neighboring states of washington. And now we understand theres been reported death in california as well. Friends and family of those people, we need to take this seriously. I also want to recognize the tireless efforts of our Public Health officials. Oregon and across the country. They have been working around the clock to coordinate a response. For the past several days i have been speaking with our governor and many state and county Public Health officials and superintendents, we had a School Closed a couple days, health care providers, and Everybody Knows theres a need for robust funding. I know we passed a bill in the house yesterday. I hope they get it finished in the senate soon. Ive also heard numerous concerns about the availability of protective equipment , particularly masks. Also staffing challenges and testing ability. Those who have covid19 can remain in sick remain a symptom at it for several weeks. Was talking about even greater risk, furloughed healthcare workers in my district. The cdc expanded its guidance for testing but there is still a significant amount of confusion about who should get tested and how those increasing testing capabilities can best be used to inform and improve our response efforts. You heard this morning south korea is testing 15,000 people a day. We cannot get an accurate picture of the infection if we are not testing. Until recently the testing was limited to those who had recently traveled to places with high rates are those showing symptoms after close contact. I understand the process of getting to test out into the field is slow. We had the test sent to the cdc on friday, and it did not come back until thats really hard tuesday. For a community that is wondering what is happening. Can you explain the scope of the cdcs guidance, was that based on best practices or was it inappropriately limited because of a lack of capacity to test . Hard tonstein it is delve too deep here. Often times people might be showing symptoms and may not be even interacting with a healthcare provider, so we dont actually know the whole scope of the number of cases that are out there. You mentioned a great point about impact in the Health System. We are really advocating for and tools that help at the front line. Beyond the point where someone is actually helping to come in and end up in an emergency department. Theres opportunities to think about tools that can integrate data to the cdc but also have virtually providers. This is a real important component. We suspect an influx of people coming into our Health System. Were very nervous about the flooding of our Emergency Departments with potential cases. The opportunity is bring Digital Tools and Innovative Solutions along with the integrating of testing. Homebased testing and other opportunities are really things that we advocate for because lack of opportunities for someone to come and meet with someone live. After the fact that we can actually begin to understand the depth of what is happening in the population and again those kind of data points are so critical now to understand more broadly what is happening in the community. As i mentioned, the test presumptive on friday, and then went to the cdc, did not come back into tuesday. Can you elaborate on the ideas of why we are seeing such delays in testing. The recent emergency authorizations, will expedite things and what else can we do to increase the availability and accelerate the testing. Four brief points around that. And thank you for the question. I think the first is, respiratory virus is not trivial because you often and we seen this in china, is actually not unusual, if you look at the literature on testing for testing for viruses, you get negative results several times and all of a sudden it is positive. A true false negative or is it because the tents the test was not sensitive enough . It takes time to really fine tune these testing for respiratory viruses. In fairness to the cdc, testing developing new diagnostic test just like developing it vaccine in the middle of a crisis. To develop a new technology, for a new age of Public Health crisis is one of the hardest thing that we do as a nation. So its hard to make that go quickly. I understand we couldve done better. As a country we should have but getting those kits out there, i think we will get up to a million eventually. I believe the Vice President had mentioned that. But as we do that, i think we have to prioritize who gets the test. My recommendation would be that we focus testing strategically around protecting our three most vulnerable populations as i mentioned. Our older residents in the Nursing Homes, places of assisted living, they are highly vulnerable and their mortality is ten to 15 percent. Healthcare providers. And protecting our first responders. If they go down, everything collapses. But then even after that, the other thing that not a lot of people talk to about, this is not adequate. We have to wait hours or days for the test results, thats a limited use to us. We need rapid test. Let me recognize it gentleman from florida for five minutes. Thank you. I only regret the conflict with members only briefing taking place simultaneously, and thank you witnesses for the important work you do every day. Thinking about ways to combat Public Health threats. Theres a common theme in the testimony which is when there is a crisis, all eyes turned to you. But when the disease or moves off of the front pages, the public loses interest in the funding goes away. You didnt say this part but i will say this also that we see the problem, have is to throw billions of dollars at it is a look now we have done our job. We hope for a good result. Then we going to the next issue. And of course theres always the fingerpointing and blaming. Based on as you well pointed out earlier, much information and disinformation. That is really regrettable. People are getting really tired of that. Doctor murray, working with you, you successfully identified over 1200 novel wild illnesses including 161 of which belongs to the same family as covid19. I think most of us in the room are wondering what the risk to humans is from those viruses as well. I have four related questions that i will ask you. So in addition to identifying viruses, we also have this team of modelers to help self identify where to look in the world. Also a team of experts who then rank all of these viruses pretty viruses. I wish we had enough money to look at every country and of animal, we would, but we dont we really try and use the funds effectively. We identify the countries in which are most likely to be a problem. Species that are most likely to transmit the length of disease to humans, primates bats and rodents. In the 1200 viruses, the rate according to the families that are most likely to cause a problem for health. And that is where we spend the majority of our time. Some of the most important families. Just to add on what my colleagues here said, it is a time that the funds are an issue. In the program i am describing, is in the process of being closed down. Were actually hosing holding our closeout session on march 17th if anyone would like to join us, because we will be reporting a lot of what we have done over the last ten years. My suggestion would be, this is not the time to lean out but the time we need to be leaning in. What percentage of the viruses have the potential to jump to humans . About 50 percent of those have the potential to jump to humans, based on the receptors and where they are, can attach to the trachea. But not all of those are going to spread rapidly. Not all of those are going to cause severe disease. So would look at, the 50 percent that could jump to humans. Probably only 10 percent. Cause rapidan disease and pandemic. Maybe 15 percent that can cause rapid disease and a pandemic. But until we identify those viruses of species in which they occur, the reservoir species and motive transmissions to humans, we really have tremendous risk. In the research that has shown these outbreaks are coming more and more frequently. So a lot of us have felt like, this is no surprise. The folks in the Health Community feel it is not a surprise. We have been saying collectively, these pandemics are coming. We can tell you in general, the countries are the areas and some of the risk factors and some of the viral families. You answered my next question about the percentages already. How can you best Prioritize Research . Is there a good process to set Research Priorities in place. I think a lot of what we are doing, and i thank you for this hearing. It does say a lot of the same folks in the same room to help identify the issues. From my perspective, the more that we can look at bringing experts from many different fields, from the government, universities together, and the consulates of humans physicians, well most of them are human. Humans physicians, veterinarians, nursing staff researchers, i think thats really what we need to be doing. And looking at not only in the u. S. , but in countries and other countries as well. We look at the economy lowlight, the economy globally. Its time for us to look at health globally. Thats how i would go about establishing Research Priorities. Thank you. The gentle lady from texas. Recognized for five minutes. Thank you, chairman. I want to get right to the questions. Thank you all for being here. I want to follow up with you on your opening comment and then opening up to the panel to weigh in on your thoughts. In your opening comment, you mentioned your work developing a vaccine for sars and the question, what will the ecosystem leave for vaccines that dont make money. That seems to be an appropriate question for this committee for the congress of the United States to be tackling. I would like to hear what you think it should look like. Andget others to weigh in touch on what dr. Murray said, where can we partner with other countries in doing this work . I would love to get your thoughts. Dr. Hotez there is some good news to this. We are very blessed to have a national of Infectious Diseases headed by a doctor whos been very committed to this problem. Nih, i would for not be here. They have really worked hard around trying to fix this problem. The problem is it is not enough. Fauci, hek to dr. Says, i cannot just hand over money. It has to go through study sections. Study sections oftentimes will get turned down because they will claim what we are doing is not innovative. Boring, right, it is but it is absolutely essential. We have to figure out a way for a funding mechanism to be created that will provide steady funding for scientists who are ready and able to develop the vaccine because it is overreliance on the Big Pharmaceutical Companies. They are not coming in in a big way with a couple of exceptions. The biotech, some of them are in it, not so much for the specific vaccine but the device to accelerate their technologies. So we have to figure out a mechanism to create a group of fund a group of scientists, working in an area where they will develop Nonprofit Sectors. We have done research for years, and they been hit very hard. We can restore that. We have this Great Research center at the nih. A couple of others like ours, university of maryland, college childrens. Texas each one has to be bigger and we need more of them. Also, my thanks to the nih. I also would not be here if it was not for the support of the library of medicine and their effort to really train the next generation in the data scientists and health. Your question around vaccines, thinking about the comments of dr. Murray and the next event. We need to be focused on the current coronavirus but we will likely see another coronavirus event. We saw sars, mers. Should bely we developing something that will ultimately prepare us for the next pandemic in the future . I think the better we prepare for those events, the better off we will be. The difficulties with you talked about the eco systems for vaccines that dont make money. Developing those vaccines and then testing them, but we also project at our center, manufacturing those vaccines by scale. You might be able to have a vaccine, but we cannot make half a billion doses in enough time to make a difference. So i think that is another thing that we cant just swap over the products to manufacturing plant. This is another area that really needs a lot of attention. Thank you. I agree with my colleagues in particular doctor brownstein about the universal vaccine. I think its a very good idea to invest in that. I think part of it is we would collect in the field, what types of vaccines are viruses or other vaccines or viruses are out there would informed that. I also wanted to add on, i found a little bit more about the question from mr. Posey, i do think that it we are looking at research, creating one health programs, we dont currently have a program that works in high risk areas, incorporates both the Human Expertise and the wildlife expertise, and ideally has 1 foot in the federal government and 1 foot outside of the federal government. It worse be great if some institution like were here and in dc. Perhaps an institution that already exists. The gentleman from texas, recognized for five minutes. Thank you for being here. I appreciate the healthy discussion over some of this misinformation by comes out. Sometimes with Political Goals in the dispersion of it. I also appreciate educating us on some of the real scientific challenges in addressing a situation like this. I wanted to see, in the effort of giving Good Communications on this, can you give us the back tracking of this and understanding of why are we dealing with this. Where does coronavirus come from and how is it spreading . Thank you. I would be happy to do that. I could probably show the answers to that question as well. In terms of what we know, primates and rodents are the species that are the most likely to carry these viruses and transmit them to humans. The coronas in particular, in a team is already discovered several other coronavirus is in china. They are very closely related. And you can determine how closely this virus is related to the other coronas. We found some in myanmar that are not closely related. We also have people looking at the risk associated with that. In a lot of countries, bats provide a lot of protein. People do eat that. If you think the right on the risk might not be the person in a restaurant eating fully cooked bat. Perhaps the risk is the woman in the back preparing the bat without the gloves, and without the mask. And they along with children, will take it home. Trying to understand the cultural norms of Human Behavior patterns that contribute to the se sorts of things. We also have a pandemic preparedness science and Technology Panel that looks at these things. Smithsonian we hosted a two day workshop looking at the soft scientists and the hard sciences. And modelers look to the Human Behavior. The heart scientists look at what the virus does. We believe the wildlife markets and the trades are a really huge risk in general. The risks are different whether youre in africa or in asia. African animals tend to come to the market, the risk is more for the folks in the forest killing the animals. The meat tends to come to the market already dead. Animals they are live at the market. Relatedve it is a bat virus and it came in close contact through the markets. We still have so much lot more to learn about this in particular. Epidemiologists and human health folks as well. Theres still so much we dont know. Thats what we know so far. I would like to yield to our colleagues if you have something to add. If you can tell us what some of the challenges in addressing the treatment and faxing. I will just get all the questions out here. Based on your working with sars and ebola, what are some of the challenges that you see governments have faced in the past and practices we have learned . What are some of the things that this . Some of the things that we can use in addressing this . Two points. We need more vaccines. And trying to do this in the middle of a crisis, is very difficult. The story with ebola, and yemen, so we want to start doing this now. So one of the other problems that i am seeing, through naid and barta, we have incredible mechanisms for supporting the vaccines. Clearly the u. S. Is the Global Leader in this. We need some of the other countries to start hoping with the Global Health technologies. If you look at the public funding globally, the u. S. Is by far the number one in the uk second and European Union and that the bottom falls out. So we see a lot of underachievement among the g20 countries. China is doing very little, japan, not much. A little bit in korea. Brazil needs to step up. So we really need to put this on the agenda of the g20 summit to say, look, the u. S. Has globally taken the lead on recognizing this is a huge problem. The other countries need just need to step up. One of the books i wrote is called blue marble health. It finds that overwhelmingly most of the worlds emerging it relatedrated poverty diseases are not necessarily the most devastating countries in africa. It is in the g20 countries. The poor living among the wealthy including 12 million americans have suffered from a neglected tropical diseases. So we need the others to show some leadership. And work of the state departments and others. Gentleman from california. Recognized for five minutes. I think the chairman and the witnesses. Very useful and informative. How can social sciences aid us how to stopding misinformation during an outbreak . Misinformation during outbreaks is the big problem. I think it is a very complex problem. So social scientists can help us understand with the best messages are to help people understand when the rumors theyre seeing are false. So to improve our messaging, the type of ways we are trying to communicate with people, how to convince them the facts rather than believing in these rumors. I also think that there is an we need to develop an entire strategy here. We need to think about all of the different stakeholders. Tech Companies Need to be doing work. We have the public, you cant just say to the public, we think the public to figure out how to determine truth from falsehoods. We also have governments, news media, and we have Public Health. We have to think about those stakeholders and everything they can do to deal with this problem. Ofis there a specific Area Research that would help develop the tools . I think that looking into see what misinformation is out there, that i think its looking at what kind of ways you can solve that. Thank you. I am going to follow up on ms. Letchers question prioritize pharma and biotech with Vaccine Development . Ive been critical of the Big Pharmaceutical Companies today but also have some great support as well. What merck and company did, with the ebola vaccine, is an extraordinary story. That vaccine, ultimately, given to 200,000 people in the middle of a war and conflict, prevented a catastrophic epidemic that would have dwarfed the one in west africa and destabilized the entire african continent. We go a real though we so we owe a debt of gratitude to them make that happen. But if you talk to some of these people from merck, they say we did not make money on this thing. They say depending on how you crunch the numbers, we actually may have lost money. We had to pull people from moneymaking projects and put them on this. It is really a problem. Vaccines are expensive. They are expensive because of all of the Quality Control and assurance that you have to have. All of the belt and suspenders to assure the safety. Maybe thats one of the reasons we are not seeing the Big Pharmaceutical Companies jump in. Merck had tok what do in order to make this happen. I think we have to look at creating a new type of organization. And maybe working this out in the Nonprofit Sector here in the United States. I am pretty excited excited about health map. How is Artificial Intelligence used in Health Preparedness . Ai is seeing an explosion in health care. There are opportunities leveraging ai with large data sets. Dealing with Public Health crisis, there is a huge amount of data. A lot of information, a lot of disinformation. And be able to sort through all that Critical Data, we can use our modelers, our policymakers, thats where these kind of methodologies come into play. So, if you think about the earliest signs of the covid19 event, they are actually through these collecting tools, the technologies that doctor murray was talking about. Coming through the web, looking for signs of these illnesses that we could neutralize in those this point and then communicate those to the World Health Organization. More importantly, theres a vast amount of information globally now. Trying to understand the response and recovery the Demographic Data and that is so what we are trying to do is to augment the work of these Public Health practitioners through the opportunities that ai brings. Bring that Situational Awareness data to the forefront so it could be used effectively. I am going to ask you for the record what the challenges are in expanding ai . The gentleman from texas. I think the chair and welcome our four witnesses. A special welcome to doctor peter hotez. I would like to join my texas colleague in bragging about dr. Hotez. Not just man who is an expert in texas. He is an expert globally on pandemic viruses. And thats why you saw him all day yesterday on National Cable explaining challenges with the covid19 virus. You also saw him do that with sars and h1n1. That one broke out in 2009. Texas Childrens Hospital set of vaccines in the parking lot overnight. In, itr class you are dont take long to call the roll. I want to talk about the quality treatment and future responses. Quality treatments. Yesterday, it was announced that my home county was the first site in texas to have a of the covid19 virus. Dont know too much. The man was 70 years old, he traveled overseas. Toconfirmation he went china, iran, or italy. He is now quarantined a local hospital. The doctor mentioned a lot of people right now are living in fear that this disease is amongst the people of my hometown. And those fears may cause people to do something that is not very wise and is sometimes very foolish. Weve seen photos, all across towns reactingf to this. Empty shelves in grocery stores, weve seen empty shelves of bleach. People think that drinking bleach can somehow help, which is just crazy. We see empty shelves of canned foods. We see at the home depots, the lowes, all of the things that needed to protect people are being swarmed up by people who do not need them. Doctor, you brought this up yesterday on national tv. We make sure that the required resources are given to the Top Priorities. Neighbors,ictims, the ems vehicles, the cops and the firefighters and doctors and nurses. How do you make sure that those are the people who get the First Priority to these scarce resources . Thats exactly right. Thank you for those really generous comments. 4 need to give our 1, 2, 3, Top Priorities to the groups that were going to ensure that if they go down, things fall apart and things go badly quickly. Protecting our older individuals in the Nursing Homes. We now know, anytime a virus is in the community, those are the ones who are going to get hit the hardest. Beenther thing i have saying is regarding panic. You will have time. Its not like you going to wake up tomorrow morning and find that the entire eastern half of the United States is infected. What we are going to see is multiple communities. Affect. Communities being affected. But you will have time in order to prepare and figure out what is happening. We dont exactly know. It may stop there. There are some who believe there may be seasonality to this virus. We do know that it all. So i think the key is to stay in contact with people, hold those but also try not to sugarcoat. Its a real art to be able to give difficult information but to do it in a way that we say we are aware of it. Here is what we are doing about it. Weve been through this before. I think one of the things that i have noticed, in 20 years that i have been following pandemics, since anthrax in 2001 and sars in 2003. H1n1, then zika. The same thing happens every time. It takes us a little bit of time to get our arms around it. There are always stumbles in the beginning. A lot of it has to do with the federal and state governments have to figure out all over again how to Work Together. So there always seems to be that new Relationship Building that has to happen. And then eventually we get it right. And this will happen again. And i think the other thing that we want to see is the press not piling up too much. Put look with that good luck with that. During theppening democratic primary. It is happening at the worst time possible. And the perspective of time frames, this always happens in our time. Thank you. Thank you all for coming. I want to follow up on the questions about Vaccine Development. Thank you for clarifying we are not going to have this vaccine for a year or so. Can you share some of the risks of bringing the vexing to market to worley . Two early . Too early . The risk is compromising safety. Remember what we are doing, were going to we are going to be immunizing healthy people. Vaccines always have a higher safety bar. You are injecting well people. When you are trying to accelerate some technology for compassionate use. And our fda has one of the best track records in the world in ensuring safety. And we have one of the best Monitoring Systems in the world on ensuring safety. We have these four systems in place. The reporting system, and many times people think thats only the only thing we have. We have a redundant system around four tracks that follow this. So we know how to do this. We know how to ensure that vaccines can be developed and tested safely. Dont try to pressure fda into doing something that breaks with that, because if we start rolling out a vaccine to too quickly, and it is shown that a number of those individuals are getting worse because of this vaccine, which we know can happen, we have seen it with other coronavirus vaccine, then people will lose confidence not only in the coronavirus vaccines, but our whole vaccine safety network. With the nonvaccinated population, given some of the early data, seems to suggest those most at risk are the elderly and immunocompromised. And healthcare workers. So we are not going to have a vaccinated population. Presumably other complications that people have may be at risk. As you look at the Broader Health care ecosystem, do you see other medications that we may be increasing focus on some of these none coronavirus things and maybe what will ultimately hurt people . Maybe we should be looking at the ecosystem right now. Even though that is going to take, whatever time it is, there are other technologies out there that we could be using that will get deployed more quickly. Im sorry, im asking a different question. Maybe it is my own lack of knowledge. An example, i am taking suppressants because i just had a liver transplant. And all of a sudden i come down with coronavirus. That may not be the best thing for me with what this other thing does. So if you look are most at risk from getting a bad flu, are there other drugs and pharmacological that is disproportionately taken that we should be concerned about our or maybe a little focused on how we can protect some of these folks . I will have to think about that a little bit more. But youre right, we dont have, remember this is a new virus. New virus agent. There are differences in the u. S. And chinese populations. Weve not seen a lot of data immunosuppressive drugs. I dont think we really know what that is. Im using that as an example. My concern is people that might be needing other things. I appreciate your comments on on not spreading misinformation. Given what you researched on ebola, and without making this a political conversation as you look at what is going on right now, are there specific pieces of misinformation that trouble you . And if you were in her shoes, what would you like to see us bring to the country this weekend . To bring up something that is very important, because influencers like you have one of the biggest roles in spreading the truth about this disease. That is actually borne out by the research. I think when you go home, i think people might be afraid. I think this is a concerning disease. You cannot sugarcoat it. This is serious. You need to think of it and think about the ways we can prepare. Research has shown the people really want to know more about the actions that they can take rather than the risks they have to worry about. The cdc has a lot of advice out there. Wash your hands, use etiquette. Respiratory etiquette. I think people also want to think about how they can be prepared and how they might take care of her loved one. If one is sick but not enough to be in the hospital. They were limiting how many people we are trying to take care about the hospital. How we might care for sick people at home and think about stockpiling prescription meds that they might need. You dont want to be at the store for theres a lot of sick people or whatever. I think actions are really what needy people need to hear right now. Thank you. You, mr. Chairman. Dr. Hotez, you have a great backgrounds. Its not every day that we get an olympic athlete in our midst especially one that had world a world record at one point. Still unbelievably incredible. Of all of the accomplishments, i respect most about the fact that you have my wifes unyielding admiration and appreciation that a member most to me as of many years. I want to start asking about the that diagnostics play in forecasting accuracy. Briefing. T a it is very obvious we dont have the number of diagnostics available with respect to coronavirus today. So when it comes to your forecasting accuracy, what role does having robust diagnostics play in the process . Thats a great question. Diagnostics have an incredible way to play because, the that you look for information out there about the disease the temperance what you will find. You are never going to say, we have Community Transmissions. Every case you find will have a travel history. As i think that being able to the testostics like studies is really important so that we can note those more mild cases in the range of disease and where it is. From a from a modeling perspective, having an accurate understanding of the community is incredibly important. It might lead to overestimating fatalities. We dont actually know what is happening at the Community Level because we dont have the testing. We are going to be essentially biased because we did not have an understanding, such as household transmissions. What we are seeing in terms of the little level of spreads in what is happening. Incredible and south korea, they are testing all the time. It seems like drivethrough testing. Whereas here, it is unclear to me how many people we have tested. I dont think it is north of 1000. I could be wrong. That has been a little troubling. I guess followup question on the model piece. Thee had been testing on order of south korea, how much further along do you think we would be, and how much closer to being able to more effectively prepare and prevent a major outbreak . Would we be if we had the better testing capabilities . I will be quick. If we had had better tasting capabilities, i think we would have had the motivation to get moving a little bit quicker. And especially in places where we might see disease so that we can keep it out of those Nursing Homes and hospitals. That would have been helpful. Exactly the same thing. The more detailed information we have on the ground, the better off we are to respond. If we have richer information about what is happening, we have the testing, we can understand what is happening at the Community Level and think about things like social isolation and other mitigation efforts that could help with that spread of the coronavirus. With my final minute, i want to go back to the question with respect to false information. Obviously since 2014, ebola, the platforms that were used in the ways we communicate has changed quite a bit. Have you noticed a difference, a stark difference of any kind of between how misinformation was spread in 20 versus how it was spread today . Was sort of lessons can we learn from that . This is an opinion without an analysis behind it. I think the spread of misinformation has been much more rapid. We know that in some cases is in some cases it has been coordinated and think that it spreads across multiple platforms very quickly. We have these echo chambers and we had them in 2014, but misinformation bounces within people who have the same belief system. Thank you. Ive been sitting here trying to synthesize from your testimony what a coherent plan to try to do something over the next decades that would really move the ball. The first step it seems to me is to actually characterize up to 1. 7 million potentially transmissible virus is. I think there may be hope for developing technology so that we 1. 7 million sounds like a big number, but with technology development, you might be able to bring the cost down. Fromtigate transmission animal reservoirs and things liking drives and other things. They are talking about releasing mosquitoes that cant transmit certain things. Certain parasites. That sort of approach may be important. Secondly to simply identify sequences across the broad classes. There was an example of this in my district. The recently solved a protein nsp 15, which is involved in the replication of the coronavirus. But actually, do something that would persist over time longer congresss then attention deficit disorder. To actually stay focused on a handful of attractive targets or large number of attractive targets and develop these four these drugs as treatments or vaccines. The vexing problem is much tougher, because of the Clinical Trial. I dont know if there are any. Breakthrough ideas. If you have thousands of potential viruses and everything about them understood but you have not been a Clinical Trial on the identified targets, but you still need to go need Clinical Trials, are there any technologies out there . It seems like an unsolved testimony. The and for the developing highvolume generalpurpose many fracturing that is on standby, which is something that the doctor mentioned. It seemed like something where you can throw money at the problem. If there are really generalpurpose technologies out there, theres a lot of overlap with this frankly with money we are spending on bioterror defense. And it might be this exact same equipment that you need. Have i missed any big parts of this . Detection is something you mentioned that is sort of a parallel track. If i may add one more component. The idea for a national or International Service forecasting, weve done this for the weather. We collect data and make predictions. That does not exist today for disease forecasts. It would be developing a way to predict the next sort of coronavirus like pandemic. I think you point out a very good bottleneck in the clinical in that clinical testing does take time. There have been a lot of effort to apply innovation towards streamlining clinical safety testing. Sometimes we call it systems vaccinology. In fact it was already started with the ebola vaccine in the congo. We got information on the efficacy and safety in record time. I think i was in for this particular safety signal around this enhancement problem, we might have broken a record, because there is an appetite to figure out how to streamline vaccine safety testing. ,t is just there is a unique quirky feature about coronavirus vaccines and other respiratory virus mexicans. Respiratory virus innovations. When we come up with these tools, they are interesting and exist out there, but we really need a way to sort of integrate them into practice. So i think practice focus research at the cdc is really important to make sure that we actually move research and make a difference on the ground. It. Have there been big studies that actually come up with plans, budgets . Is this something that it was some 15 years ago or ignored by congress . Lets just sit down and do an International Context to come up with a plant that has those elements are mentioned and others. I can answer part of that. To answer the first part of your question, there is a group that is looking at the 1. 7 million as yet unknown viruses. Their goal is to identify and characterize all of that. Much in the same way as the human genome project started. We have had for the last ten years, a Global Program looking at human and Animal Health as well as surveillance in send drum like surveillance in countries, laboratory buildings. That is someone i was describing in the process of shutting down now. I would suggest that this is not the time for the u. S. To be pulling out but if we have a program that is doing it, if anything else, we need to continue and expand and incorporate more of the type of folks we have here. Part of that program also im sorry, we are running out of time here. One must question in. The gentleman from virginia. Thank you. Thank you all so much for being here. 30 years after first coming across your incredible landmark hope warm vaccines. Its nice to see you again, dr. Hotez. Ill start by submitting a letter. If there is no objection, mr. Chairman. Hate asking us or no questions because they tend to be doctored questions, but time allowing there will be tempora paragraph questions later. I would like to make this a quick point. Five yes or no questions would be helpful. Says the death rate is over 3 of those affected. Do you have any reason to believe the actual figure is a fraction of 1 . A fraction of 1 . Yes. Ok, thank you. Would you say the World Health Organization statistics on the spread of the Coronavirus Spread is false . No. Will we have a vaccine soon or within a few months . No. Are we likely to get a quick cure . Mean bye do you cure you mean a treatment . Are people too go to work and risk spreading the disease . No. Would you say the danger of american lives have spread disinformation to get people to go to work and potentially spread the coronavirus because the public was misled on the dangers of this deadly disease . Misleading the public on a disease is wrong. The sad part is these statements, which most scientists, every scientist today would agree endanger american lives were actually made by our president. So large audiences in the last three days. They just told me trumps coronavirus statements about a soon, quick vaccine, quick cure, its ok to go to work, that all these things are endangering american lives. And to be clear, the cdc advises anybody with the symptoms of coronavirus such as a fever, coughing, shortness of breath should stay home from work, avoid public areas as much a as much as possible and seek medical attention. The tuesday briefing from Vice President pence was not televised. He came here and spoke four different times on monday. We had reports about how Many Americans are being tested. Uncertainty ingh the face of a likely pandemic, should the American Administration be more transparent or less . Doctors . I will just be quick. The administration should be transparent, they should be clear about what they know, the they should tell the truth, be clear about what they dont know, what they are trying to do to find out those missing pieces of information. And be clear about what the course is and what information might change that course. Thank you. We have heard a claim focusing on testing is a longer needed once the disease has spread. If its in the community, testing is moot. We have also heard testament that would that they would rather over test a fan under test. Do you think the testing will still be valuable when the sources spreading to the committee customer. I think its important to actually have an accurate picture so the dynamic of this virus is going to change from community to community and we need to understand the impact its having to scale is critical. So just like we do this for the influence on a seasonal basis will retest the fluid to underlying illnesses. We need to do that to scale with coronavirus makes a lot of sense. Youve done so much work on vaccines over the decades, you testified earlier quite well about it. What is the best the American People can hope for in terms of a quick vaccine . Or a soon vaccine . I think it is really important to remember that vaccines are not quick. And that has a lot to do with Vaccine Confidence in the United States. As you know, we have a very aggressive Antivaccine Movement in this country. As of the last couple of years, its affecting Public Health. Measles came back in 2019 because of the Antivaccine Movement. So we may be battling two epidemics. We still have 16000 americans who died of flu, we have a hundred not getting vaccinated. I think its important to not tell the American Public that we will have a quick vaccine because thats not how works. We have to assure the public that we do not give out vaccines unless they are thoroughly tested and they are the most thoroughly tested pharmaceuticals we have for safety. Hotezant to thank doctor for leading the fight against antivaxxers. Before i bring this hearing to a close i want to thank all of our witnesses for testifying before the committee today the record remain open for two weeks for additional statements for members and any additional questions the committee may ask of the witnesses. With that, the witnesses are excused and this hearing is now adjourned. [captions copyright National Cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] announcer cspans washington journal, live every day with news and policy issues that impact you. Coming up friday morning, we will discuss the u. S. Response to the coronavirus outbreak with doctor christopher morris. A Global Health professor at George Washington university. And adrian of the National Association of county and city Health Officials. Watch cspans washington journal live at 7 00 eastern on friday morning. Join the discussion. Announcer here is a look at our coverage friday on cspan. Eastern, the steps local Health Officials are taking to prepare for the coronavirus. Cap 1 30, Johns Hopkins in health anderts Emergency Preparedness provide an update on the coronavirus at a briefing in capitol hill. On cspan2, a discussion on Coronavirus Response with 2 former Obama Administration officials. Center fore from the 30erican progress at 11 a. M. Eastern. This electioning season, the candidates beyond the talking points are only revealed over time. But since you cant be everywhere, there is cspan. Our campaign 2020 programming differs from all other political coverage for one simple reason it is cspan. We have brought you on filtered views of government every day since 1979. And this year we are bringing you unfiltered views of the people looking to steer that coverage this november, in other words, your future. This election season, go deep, direct, and unfiltered. See the biggest picture for yourself and make up your own mind. With cspan campaign 2020 rep to you as a Public Service by your television provider. Announcer following the results of super tuesday, Elizabeth Warren announced she is suspending her president ial campaign. She declined to endorse another candidate at this time. She spoke to reporters outside her home in cambridge. [cheers and applause] we love you barking] thank you [applause]